Question Interhemispheric inhibition (IHI) is a crossed, transcallosal inhibitory relationship between the left and right motor cortex (M1). This can be assessed in vivo using transcranial magnetic stimulation (TMS). Interhemispheric interactions may be altered in disease such as stroke where IHI imbalance is a potential target for therapeutic neuromodulation. IHI is well defined in adults, but its properties in the developing brain are poorly defined. Methods 24 typically developing, right-handed children aged 6–18 years completed a TMS-evaluation of transcallosal inhibition. Bilateral ipsilateral silent period (iSP) measures delivered suprathreshold (120% resting motor threshold, RMT) stimulation during 50% maximum contraction of the ipsilateral first dorsal interosseous. Bidirectional paired-pulse IHI (LtoR and RtoL) delivered a 120%RMT conditioning stimulus prior to contralateral 120%RMT test stimulus at interstimulus intervals (ISI) of 8, 10, 40 or 50 ms. Results Left iSP latency ( r = −0.38) and suppression ( r = 0.48) correlated with age and degree of handedness ( r = 0.49). Right iSP was not associated with age or handedness. Children exhibited IHI in both LtoR and RtoL directions with maximal reduction of 70% in RtoL at a 40 ms ISI. RtoL IHI was greater than LtoR at ISI of 10, 40 and 50 ms. IHI was positively correlated with handedness in both directions ( r = 0.47): more “right-handed” subjects had less IHI. iSP suppression and LtoR IHI were negatively correlated ( r = −0.53), whereas iSP suppression and RtoL IHI displayed a positive correlation ( r = 0.52). Conclusions Interhemispheric inhibition is measureable in children with TMS. iSP and IHI demonstrate developmental effects of age and laterality. In contrast to some adult descriptions, elements of iSP and IHI appear to be associated. Understanding the developmental profile of IHI and iSP may inform the study of interhemispheric neurophysiology in pediatric disease states.
Read full abstract